A Call for Ethical Hygiene, Consumer Protection, and Remedial Laws
By Humphrey Makuyana
1. Introduction
Healthcare in Zimbabwe, like elsewhere, is both a social right and a moral obligation of the State and its institutions. Yet, patients often find themselves treated not as vulnerable citizens in need of care, but as consumers within a profit-driven market. A particular cause for concern is when health insurance institutions double as healthcare service providers. While this arrangement may be defended as efficient, it poses a dangerous conflict of interest that erodes trust, compromises quality, and exposes patients to exploitation.
2. The Conflict of Interest in Zimbabwe
In Zimbabwe, health insurance schemes were originally created to provide financial security and equitable access to medical care. Over time, however, some institutions have assumed the dual role of both insurer and provider. This structural overlap creates a conflict of interest:
As insurers, their duty is to control costs and limit payouts.
As providers, their interest lies in maximising charges and service use.
This contradiction results in:
Unfair pricing models that burden patients.
Restriction of patient choice, where consumers are coerced or incentivised to use insurer-owned facilities.
Opaque billing practices, where charges lack transparency and accountability.
Claims disputes, in which the insurer’s financial interests overshadow patient welfare.
In such cases, the patient—the weakest actor in the triangle of insurer, provider, and regulator—bears the full brunt of systemic exploitation.
3. The Need for Ethical Hygiene
Zimbabwe’s health sector requires ethical hygiene, meaning a cleansing of exploitative tendencies and a recommitment to fairness and dignity. Patients must be recognised first as citizens with rights, not merely as clients or commodities. Ethical hygiene calls for:
Transparency in service charges, claims processing, and patient rights.
Separation of roles, ensuring insurers focus on financing care while independent providers deliver services.
Patient-centered care standards, anchored in constitutional and statutory obligations.
4. Possible Remedial Laws and Actions for Zimbabwe
To safeguard healthcare consumers, Zimbabwe requires systemic reforms that strengthen patient rights and regulate institutional behaviour:
1. Legal Separation of Functions
Prohibit or strictly regulate health insurance institutions from directly owning or controlling healthcare facilities.
2. Consumer Protection Statutes
Extend the Consumer Protection Act to explicitly cover healthcare, recognising patients as consumers with enforceable rights.
3. Transparent Tariff and Pricing Frameworks
Mandate the publication of standardised medical tariffs, reviewed and approved by regulatory authorities.
4. Independent Oversight
Empower a health sector regulator or ombudsman to investigate complaints and enforce compliance.
5. Ethical Enforcement Mechanisms
Strengthen medical councils and associations to hold both insurers and providers accountable for conflicts of interest and unethical conduct.
6. Patient Choice Guarantees
Protect patients’ right to freely choose healthcare providers, even when insured, without coercion or punitive restrictions.
5. Conclusion
The Zimbabwean healthcare sector faces a growing dilemma: health insurance institutions acting simultaneously as financiers and providers of care. This dual role creates a conflict of interest that undermines consumer rights, fosters unethical practices, and places patients at the mercy of institutional profit motives. Addressing this challenge requires more than policy tweaks—it demands systemic reform, ethical hygiene, and robust legal safeguards. Protecting patients as healthcare consumers is not just an administrative necessity; it is a moral and constitutional imperative to uphold the dignity, health, and justice of every Zimbabwean citizens.
About the Author:
Humphrey Makuyana is a Governance Strategist. He advocates for ethical leadership, civic empowerment, and democratic accountability.
He writes in his own capacity.